老年癌症疼痛治疗的研究进展
摘要
<正>随着全球人口老龄化,老年癌症病人的比例相应增加,约60%的癌症病人年龄≥65岁,在这些老年癌症病人中中晚期的疼痛尤为多见,而其中≥30%的老年癌症病人疼痛未能得到有效治疗,这是非常重要的社会医疗问题~([1-2])。如何处理老年癌症病人肿瘤本身引起的疼痛及癌症相关疼痛越来越值得我们关注。本文现就老年癌症病人疼痛病因、病理生理改变、治疗方法进行综述。
引文
[1]Balducci L,Beghe C.Cancer and age in the USA[J].Crit Rev Oncol Hematol,2001,37(2):137-145.
[2]Mercadante S,Fulfaro F.World Health Organization guidelines for cancer pain:a reappraisal[J].Ann Oncol,2005,16(Suppl 4):iv132-135.
[3]Urban D,Cherny N,Catane R.The management of cancer pain in the elderly[J].Crit Rev Oncol Hematol,2010,73(2):176-183.
[4]Meulenbeld HJ,Creemers GJ.First-line treatment strategies for elderly patients with metastatic colorectal cancer[J].Drugs Aging,2007,24(3):223-238.
[5]Kim CA,Spratlin JL,Armstrong DE,et al.Efficacy and safety of single agent or combination adjuvant chemotherapy in elderly patients with colon cancer:a Canadian cancer institute experience[J].Clin Colorectal Cancer,2014,13(3):199-206.
[6]Turner NJ,Muers MF,Haward RA,et al.Do elderly people with lung cancer benefit from palliative radiotherapy?[J].Lung Cancer,2005,49(2):193-202.
[7]Sze WM,Shelley M,Held I,et al.Palliation of metastatic bone pain:single fraction versus multifraction radiotherapy-a systematic review of randomised trials[J].Clin Oncol,2003,15(6):345-352.
[8]Addeo R,Nocera V,Faiola V,et al.Management of pain in elderly patients receiving infusion of zoledronic acid for bone metastasis:a single-institution report[J].Support Care Cancer,2008,16(2):209-214.
[9]Reisner L.Pharmacological management of persistent pain in older persons[J].J Pain,2011,12(3 Suppl 1):S21-S29.
[10]易基群,王秀文,梁继珍,等.羟考酮缓释片对老年癌痛病人滴定治疗的可行性和疗效[J].中国老年学杂志,2014,34(24):7082-7083.
[11]温林春,陆锡燕.芬太尼透皮贴剂联合塞来昔布治疗老年中重度癌痛的疗效[J].包头医学院学报,2015,31(2):62-64.
[12]刘宁红,吴海玲.盐酸羟考酮缓释片联合加巴喷丁治疗老年重度癌痛的临床观察[J].中国药物与临床,2015,15(9):1301-1303.
[13]Nishihara M,Arai YC,Yamamoto Y,et al.Combinations of lowdose antidepressants and low-dose pregabalin as useful adjuvants to opioids for intractable,painful bone metastases[J].Pain Physician,2013,16(5):E547-E552.
[14]Carlson CL.Effectiveness of the world health organization cancer pain relief guidelines:an integrative review[J].J Pain Res,2016,9:515-534.
[15]Lipton A,Fizazi K,Stopeck AT,et al.Superiority of denosumab to zoledronic acid for prevention of skeletalrelated events:A combined analysis of 3 pivotal,randomized,phase 3 trials[J].Eur J Cancer,2012,48(16):3082-3092.
[16]Meuser T,Pietruck C,Radbruch L,et al.Symptoms during cancel pain treatment following WHO-guidelines:a longitudinal followup study of symptom prevalence,severity and etiology[J].Pain,2001,93(3):247-257.
[17]Khosla A,Adeyefa O,Nasir S.Successful treatment of radiation-induced proctitis pain by blockade of the ganglion impair in an elderly patient with prostate cancer:a case report[J].Pain Med,2013,14(5):662-666.
[18]马燕,师玉险,殷风华,等.皮下植入式硬膜外镇痛治疗高龄晚期癌痛疗效分析[J].山西医药杂志,2014,43(10):1184-1185.
[19]Xie P,Zhao Y,Li G.Efficacy of percutaneous vertebroplasty in patients with painful vertebral metastases:A retrospective study in 47 cases[J].Clin Neurol Neurosurg,2015,138:157-161.
[20]Chen L,Huang H,Sharma HS,et al.Cell transplantation as a pain therapy targets both analgesia and neural repair[J].Cell Transplant,2013,22(Suppl 1):S11-S19.
[21]栗晓,马超.细胞移植治疗顽固性癌痛[J].中国组织工程研究,2012,16(33):5848-5852.
[22]王娜,周雍明,杨宗艳.复方苦参注射液治疗80例老年晚期肺癌的临床疗效观察[J].中国医院用药评价与分析,2009,9(5):387-388.
[23]缪希莉,梅四清,张冬鑫.鸦胆子油软胶囊对老年骨转移癌病人临床症状及生存质量的影响[J].中国老年学杂志,2016,36(9):2164-2165.
[24]侯广云,张丽香,鲁丽君,等.针灸联合药物缓解老年癌痛的临床探讨[J].中国伤残医学,2015,6(23):79-80.
[25]米建平,邓特伟,周达君.火针为主配合三阶梯止痛法治疗胃癌疼痛临床疗效观察[J].辽宁中医杂志,2010,37(10):2018-2019.
[26]Johannsen M,O'Connor M,O'Toole MS,et al.Efficacy of mindfulness-based cognitive therapy on late post-treatment pain in women treated for primary breast cancer.A randomized controlled trial[J].J Cin Oncol,2016,34(28):3390-3399.
[27]Nipp R,Sloane R,Rao AV,et al.Role of pain medications,consultants,and other services in improved pain control of elderly adults with cancer in geriatric evaluation and management units[J].J Am Geriatr Soc,2012,60(10):1912-1917.
[2]Mercadante S,Fulfaro F.World Health Organization guidelines for cancer pain:a reappraisal[J].Ann Oncol,2005,16(Suppl 4):iv132-135.
[3]Urban D,Cherny N,Catane R.The management of cancer pain in the elderly[J].Crit Rev Oncol Hematol,2010,73(2):176-183.
[4]Meulenbeld HJ,Creemers GJ.First-line treatment strategies for elderly patients with metastatic colorectal cancer[J].Drugs Aging,2007,24(3):223-238.
[5]Kim CA,Spratlin JL,Armstrong DE,et al.Efficacy and safety of single agent or combination adjuvant chemotherapy in elderly patients with colon cancer:a Canadian cancer institute experience[J].Clin Colorectal Cancer,2014,13(3):199-206.
[6]Turner NJ,Muers MF,Haward RA,et al.Do elderly people with lung cancer benefit from palliative radiotherapy?[J].Lung Cancer,2005,49(2):193-202.
[7]Sze WM,Shelley M,Held I,et al.Palliation of metastatic bone pain:single fraction versus multifraction radiotherapy-a systematic review of randomised trials[J].Clin Oncol,2003,15(6):345-352.
[8]Addeo R,Nocera V,Faiola V,et al.Management of pain in elderly patients receiving infusion of zoledronic acid for bone metastasis:a single-institution report[J].Support Care Cancer,2008,16(2):209-214.
[9]Reisner L.Pharmacological management of persistent pain in older persons[J].J Pain,2011,12(3 Suppl 1):S21-S29.
[10]易基群,王秀文,梁继珍,等.羟考酮缓释片对老年癌痛病人滴定治疗的可行性和疗效[J].中国老年学杂志,2014,34(24):7082-7083.
[11]温林春,陆锡燕.芬太尼透皮贴剂联合塞来昔布治疗老年中重度癌痛的疗效[J].包头医学院学报,2015,31(2):62-64.
[12]刘宁红,吴海玲.盐酸羟考酮缓释片联合加巴喷丁治疗老年重度癌痛的临床观察[J].中国药物与临床,2015,15(9):1301-1303.
[13]Nishihara M,Arai YC,Yamamoto Y,et al.Combinations of lowdose antidepressants and low-dose pregabalin as useful adjuvants to opioids for intractable,painful bone metastases[J].Pain Physician,2013,16(5):E547-E552.
[14]Carlson CL.Effectiveness of the world health organization cancer pain relief guidelines:an integrative review[J].J Pain Res,2016,9:515-534.
[15]Lipton A,Fizazi K,Stopeck AT,et al.Superiority of denosumab to zoledronic acid for prevention of skeletalrelated events:A combined analysis of 3 pivotal,randomized,phase 3 trials[J].Eur J Cancer,2012,48(16):3082-3092.
[16]Meuser T,Pietruck C,Radbruch L,et al.Symptoms during cancel pain treatment following WHO-guidelines:a longitudinal followup study of symptom prevalence,severity and etiology[J].Pain,2001,93(3):247-257.
[17]Khosla A,Adeyefa O,Nasir S.Successful treatment of radiation-induced proctitis pain by blockade of the ganglion impair in an elderly patient with prostate cancer:a case report[J].Pain Med,2013,14(5):662-666.
[18]马燕,师玉险,殷风华,等.皮下植入式硬膜外镇痛治疗高龄晚期癌痛疗效分析[J].山西医药杂志,2014,43(10):1184-1185.
[19]Xie P,Zhao Y,Li G.Efficacy of percutaneous vertebroplasty in patients with painful vertebral metastases:A retrospective study in 47 cases[J].Clin Neurol Neurosurg,2015,138:157-161.
[20]Chen L,Huang H,Sharma HS,et al.Cell transplantation as a pain therapy targets both analgesia and neural repair[J].Cell Transplant,2013,22(Suppl 1):S11-S19.
[21]栗晓,马超.细胞移植治疗顽固性癌痛[J].中国组织工程研究,2012,16(33):5848-5852.
[22]王娜,周雍明,杨宗艳.复方苦参注射液治疗80例老年晚期肺癌的临床疗效观察[J].中国医院用药评价与分析,2009,9(5):387-388.
[23]缪希莉,梅四清,张冬鑫.鸦胆子油软胶囊对老年骨转移癌病人临床症状及生存质量的影响[J].中国老年学杂志,2016,36(9):2164-2165.
[24]侯广云,张丽香,鲁丽君,等.针灸联合药物缓解老年癌痛的临床探讨[J].中国伤残医学,2015,6(23):79-80.
[25]米建平,邓特伟,周达君.火针为主配合三阶梯止痛法治疗胃癌疼痛临床疗效观察[J].辽宁中医杂志,2010,37(10):2018-2019.
[26]Johannsen M,O'Connor M,O'Toole MS,et al.Efficacy of mindfulness-based cognitive therapy on late post-treatment pain in women treated for primary breast cancer.A randomized controlled trial[J].J Cin Oncol,2016,34(28):3390-3399.
[27]Nipp R,Sloane R,Rao AV,et al.Role of pain medications,consultants,and other services in improved pain control of elderly adults with cancer in geriatric evaluation and management units[J].J Am Geriatr Soc,2012,60(10):1912-1917.